Customer Satisfaction in the

Healthcare Setting
ASQ Tutorial
March 15, 2005

Dr. Lillian R. Eriksen, Associate Professor

University of Texas at Houston, HSC
School of Nursing
Why Customer Satisfaction?

 Two Sides of Quality Measurement

Needed: Professional & Customer
 Professionals review the technical/clinical
side of healthcare procedures and their
outcomes
 Mortality and morbidity
 Infection rates

 Errors

 Review of incidents for breaks in established

techniques or procedures
Why Customer Satisfaction?

 Customer Side of Quality Measurement

 Represents the customers perception of
quality (expectations vs. experience)
 Healthcare consumers expectations are
formed in various ways:
 TV shows, commercials
 Other media: newspapers, books, movies

 Previous experiences as patient or visitor

 Stories of relatives and friends

Who Are Customers?
 Customers can be external or internal
 Patients are external customers of the entire
healthcare system
 Internal customers in the healthcare system can
also be considered customers of each other at
times
 Physicians
 Nurses
 Pharmacists
 Physical/Occupational Therapists
 SocialWorkers
 Many kinds of technicians and support
staff
Internal Customer Satisfaction
 Generally ignored in the past
 More recent emphasis on employee work
satisfaction
 Particularlynoted in nursing with the issue of
the increasing shortage
 Effects of unsatisfied workers on external
customers
 Need to confront organizational and
behavioral barriers within organizations
Internal Marketing

 Efforts at internal marketing of customer

satisfaction may be needed to
 break down barriers to developing
customer satisfaction for the external
customer
 “happy campers”
 “workplace of choice”
What will satisfy customers?

 Positive affect
 Enhances problem solving
 Better decision-making
 Leads to cognitive processing that is
 Flexible

 Innovative

 Creative

 Thorough

 Efficient
Cognitive Effects of Positive
Affect
 Leads To:
 Helping
 Generosity
 Interpersonal understanding
 Thus the work environment and people
in it affect the satisfaction of the external
customers
What is Customer Satisfaction?
 What it that we are concerned about in relation
to customers?
 The perception of the quality of
care/service/product
 The varying degree to which expectations are not
met, are met or even exceeded
 Maintaining the relationship for the opportunity to
do business again.
 Hospital- projected increased revenue of
$2.3 million if satisfaction increased
slightly
What do external customers
want?
 Please! A little respect and common
courtesy.
 To be taken seriously, not dismissed.
 A responsive attitude when asking for
something.
 “Presence” of providers when
administering care.
 Continuity & Timeliness
 Safe clean error free environment
Example: Hospital Stay

 Admission process
 Couldn’t locate previous admission records
 MD that we were told to have paged was
not the one on-call
 Room not ready
 Extremely uncomfortable (pain and chills)
 Requested blanket- not available
 Required to go to the “holding” unit even
though not necessary as room was ready
Example cont’d
 On the unit
 Unit admission
 Nurse 1: “Who is the patient?”
 Patient in a lot of pain
 Kept asking health history questions
 Nurse 2 starts IV
 Leaves ‘trash’ on table
 Nurse 1 returns with IV pain medication
 Proceeds to clean up the table, discard materials
instead of administering pain med.
 Administers pain med and proceeds to ‘complete’ the
history as “I will get in trouble for not finishing it on my
shift”.
 Patient indicates unwillingness to continue until the next
morning.
 Patient resolves never to return
Key: Reliable & Valid
Measurement
 We pay attention to what we measure.
 Measured things end up in reports
 Reports get circulated
 Visual displays very useful
 http://www.brighamandwomens.org/family/
qualitycare/satisfaction.asp
Press Ganey Survey

1. Admissions
2. Meals
3. Rooms
4. Discharge
5. Physicians
6. Nurses
7. Visitors and Family
8. Tests and Treatments
9. Personal Issues
10. Overall Assessment
We Pay Attention To What We
Measure
We Pay Attention To What We
Measure
 Brigham & Women’s Hospital

Press Ganey report posted on the hospital website

http://www.brighamandwomens.org/family/qualitycare/satisfaction.asp

http://www.pressganey.com/
 Resources

 Rand Corporation:
http://www.rand.org/health/surveys/patient.english
http://www.rand.org/health/surveys/patient.spanish